Psych CASC / OSCE · Old age psychiatry — dementia neuropsychiatry
Explain BPSD management and antipsychotic risks to a family carer — CASC station
MRCPsych/FRANZCP-style communication station: explain BPSD, non-drug first approach, pain assessment, limited role of antipsychotics including mortality and stroke risk, and shared decision-making about a short trial versus environmental care.
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Target exams
Station brief
Format. Communication station, approximately 7–10 minutes after reading time. You are the psychiatry registrar reviewing the man in residential care. The examiner plays the daughter. [1]
Candidate instructions. Explain what BPSD means in plain language, why behaviour often flares, your plan to look for pain and other medical triggers, the priority of non-drug care, and a balanced discussion of a short low-dose antipsychotic only if risk remains high — including death and stroke risks — and a review/stop plan. Check understanding and invite questions. [1][2]
References5ShowHide
- [1]Kales HC, Gitlin LN, Lyketsos CG Assessment and management of behavioral and psychological symptoms of dementia BMJ, 2015.PMID 25731881
- [2]Schneider LS, Dagerman KS, Insel P Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials JAMA, 2005.PMID 16234500
- [3]Husebo BS, Ballard C, Sandvik R, et al. Efficacy of treating pain to reduce behavioural disturbances in residents of nursing homes with dementia: cluster randomised clinical trial BMJ, 2011.PMID 21765198
- [4]Brodaty H, Arasaratnam C Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia Am J Psychiatry, 2012.PMID 22952073
- [5]Wooltorton E Risperidone (Risperdal): increased rate of cerebrovascular events in dementia trials CMAJ, 2002.PMID 12451085